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Source publication
Range of motion deficits in shoulder external rotation (ER), internal rotation (IR), total rotation range of motion (ER + IR), and horizontal adduction (HA) have been retrospectively associated with overhand athletes' arm injuries.
The authors expected the incidence of upper extremity injury in high school softball and baseball players with side-to...
Citations
... It is also possible that there was insufficient time for the correction to occur. These results agree with evidence demonstrating a relationship between abnormal pitching biomechanics and greater injury risk, particularly in youth with developing musculoskeletal systems [14]. In cases of extreme pitching deviations, alternative corrective options, such as modifying pitching styles, may prove more suitable than orthotics alone for correcting faulty movement patterns [15]. ...
Proper orthosis design may help youth baseball players develop safer pitching mechanics to prevent elbow injuries. This study evaluated the impact of a custom elbow orthosis on pitching biomechanics and adverse events. Ten 11–12-year-old players (mean age 11.5 years) from a regional league team were recruited. The inclusion criteria were at least two years of baseball experience. Six players were randomly assigned to the orthosis group, with four in the control group. Anthropometric data and baseline characteristics were recorded. A video analysis assessed elbow flexion angle during pitching at baseline and at 2 months. The frequency of orthosis wear was also tracked. Adverse events during twice-weekly practices were documented. Post-study surveys evaluated orthosis comfort, stability, and safety perceptions. In the orthosis group (n = 6), four participants showed improved elbow flexion angle, and two of the six participants showed almost no change. The overall median difference was 23.5°. In the control group (n = 4), three participants showed improvement, with a median improvement of 5.5°. Twelve adverse events, including pain, were reported by players not wearing orthoses, whereas no events occurred with orthosis use. Individual players in the control group or who did not wear the orthosis correctly experienced multiple episodes of pain from pitching over the study period. This preliminary study indicates a custom elbow orthosis can optimize pitching biomechanics and prevent adverse events in youth baseball players over the course of two months.
... Shoulder ROM assessment has been used to assess the risk of injury for overhead athletes multiple times in the past [27,[42][43][44]. Moreover, the Bern Consensus Statement concluded that examination of shoulder ROM should be included as part of a proper injuryprevention strategy [45]. ...
... Total range of motion (TROM) has been defined as the sum of total external and internal rotation [56]. Research has shown that even a small difference of 5 • or more between the dominant and non-dominant shoulder can increase the risk of shoulder injury in baseball and tennis [42,57], water polo [43], volleyball [46], and in some cases in handball [58]. As in GIRD, we decided to use the larger TROM difference reported as a risk factor (>10), as previously conducted [8], since this study recruited a variety of overhead athletes. ...
Background:
The Arm Care Screen was developed to detect musculoskeletal limitations that could affect performance or even increase the risk for shoulder injuries in overhead athletes. This study aimed to assess the discriminant validity of the modified Arm Care Screen in overhead athletes.
Methods:
Sixty-two overhead athletes (mean age: 24.5 ± 4.2 years) were recruited. The athletes underwent a comprehensive Arm Care Screen evaluation, including reciprocal shoulder mobility, total body rotation, lower body diagonal reach, and rotary stability assessments. Ten different musculoskeletal measurements were independently measured by two physical therapists.
Results:
The modified Arm Care Screen showed moderate to strong associations (phi values ranged from 0.273 to 0.905) with the respective musculoskeletal range of motion and balance measurements. Sensitivity ranged from 81.25% to 88.57%, indicating a high true positive rate, and specificity ranged from 43.75% to 94.44%, indicating a moderate to strong positive rate. Positive and negative likelihood ratios ranged from 1.48 to 15.92 and 0.12 to 0.38, respectively. The positive and negative predictive value ranged from 58.14% to 92% and from 73.68% to 93.18%, respectively. The accuracy of the modified ACS ranged from 62.90% to 91.94%.
Conclusion:
The modified Arm Care Screen demonstrated promising diagnostic accuracy in identifying significant movement restrictions.
... While characteristics of muscle structure and performance are beyond the methods used in the current study, adaptations to range of motion that support a more optimal length-tension relationship between contractile elements of muscle and reduced contraction time may be a modifi cation that supports the demands of extended bouts of pitching [ 35 ] . However, if the chronic adaptations fall outside certain ranges, they may increase susceptibility for injury [ 13 ] . Oliver et al. determined softball pitchers playing with pain had signifi cantly less drive hip ER ROM than pain-free pitchers [ 36 ] . ...
Hip and shoulder range of motion (ROM) alterations are correlated with increased risk of injury in softball athletes. The purpose of this study was to investigate bilateral shoulder and hip ROM adaptation during a simulated softball double-header exposure. It was hypothesized that shoulder and hip ROM would decrease after simulated game exposure and would not return to baseline following a 30-minute break. Thirty (14.8±1.9 yrs, 162.5±18.3 cm, 71.79±16.03 kg) adolescent softball pitchers participated. Testing included: bilateral hip and shoulder ROM (preSG), simulated game exposure (100 pitches), bilateral hip and shoulder ROM (postSG), 30-minute break, bilateral hip and shoulder ROM (preDH), pitching first inning of a simulated double header (12 pitches), and bilateral hip and shoulder ROM (postDH). Two separate repeated measures multivariate analyses of variance tests determined differences in ROM between time points. Dominant shoulder internal rotation ROM and non-dominant shoulder internal and external rotation ROM significantly decreased from preDG. Stride hip external rotation ROM and drive hip internal and external rotation ROM significantly decreased from preSG to preDH. Key results revealed the break given between games may not be sufficient recovery time for hip ROM. Thus, assessing ROM as workload progresses can be a useful strategy for monitoring a softball pitcher’s injury risk.
... The most classic overhead sports are baseball (pitcher), javelin throw, volleyball (serve and attack) and tennis (serve and smash). These sports have in common the phases of the athletic gesture and a high risk of injury of the joints and the muscles of the upper limb [1][2][3][4][5][6][7][8][9][10]. ...
Background: Swimming and, specifically, front crawl, can be included among the “overhead” sports. Overhead sports are a risk factor for some problems of the musculoskeletal system, especially the shoulder. The aim of this study was to assess the incidence of shoulder and neck pain in a Masters Swimming Team and its correlation with the crawl stroke. Methods: This is an observational study through video-analysis of the stroke and a questionnaire. The participants selected for the present study were 61 athletes of a Masters team, whose prevailing training stroke was the front crawl. Their stroke was analyzed during training using a go-pro camera mounted on a sliding trolley on a track, evaluating their technical defects with their trainer. A questionnaire about frequency of shoulder and neck pain during the last five years was administered to all the participants at the study. Results: From the questionnaire, 45 and 55 out of 61 athletes had suffered from shoulder pain and cervical pain, respectively. Both types of pain were correlated with the weekly swimming volume. The swimmers with hyperflexion of the wrist and prolonged internal rotation in the pulling phase had shoulder problems. Those who suffered from current shoulder pain reduced the underwater time. The four swimmers with an excessive body roll during breathing and those who kept their heads extended, reported cervical pain. Conclusions: Shoulder and neck pain could be prevented with the correction of specific technical errors in crawl stroke.
... 9 While this extensive ROM is beneficial, it can be accompanied by joint instability and an increased risk for injury. 3,[10][11][12][13][14][15] Shoulder injuries often result in pain, stiffness, and/or limited ROM, potentially compromising shoulder functions. 3,10-15 A healthy shoulder joint is important for overhead athletes, as exemplified by extensive literature related to the shoulder for baseball, softball, tennis, basketball, swimming, and other overhead-dominant sports. ...
... Traditionally, musculoskeletal evaluations encompass a ROM assessment using marker-based assessments, which can be timeconsuming and operator dependent. 4,6,10,18 Recently, markerless motion capture systems have gained popularity due to efficiency, rapid data processing capabilities, and evidence-supporting accuracy and validity when compared with traditional marker-based systems. [23][24][25][26][27] Because of the rising popularity of markerless motion capture systems and the supported benefits of preparticipation movement assessments, the purpose of this study was to assess the bilateral shoulder ROM of firefighter trainees. ...
... 3,10-15 For example, overhead athletes are frequently evaluated for shoulder ROM, and it has been reported that deficits are independent risk factors for upper extremity injuries. 10,13,16,20 Additionally, Matsel et al. found that improving shoulder internal rotation was associated with a 36% reduction in shoulder injury risk among adolescent baseball players. 36 Although shoulder ROM data for various active populations, such as overhead athletes, can be found in the literature for clinicians and future research, similar information for firefighter trainees is difficult to reference. ...
The unpredictable environments firefighters face paired with biomechanically compromising shoulder movements, such as overhead and lifting movements, place this population at an increased risk for shoulder injury. The purpose of this study was to assess firefighter trainees’ bilateral shoulder range of motion (ROM) using the Dynamic Athletic Research Institute Motion system. Retrospective anthropometric and ROM data for 31 male firefighter trainees were analyzed. Firefighter trainees’ mean shoulder ROM for bilateral external rotation, internal rotation, and extension were lower than previously published values. External rotation demonstrated the lowest percentage of trainees within normal ROM (left—6.67%, right—16.67%). Noting the susceptibility of upper extremity injuries among firefighters, establishing baseline ROM measurements for reference may improve musculoskeletal evaluations, training interventions, and injury rehabilitation.
... Regarding the ROM, a significant reduction was only found in the IR of the dominant shoulder. This is important, since increased ER and decreased IR are generally observed in overhead athletes [14,38,39]. Reduced shoulder IR can be derived from a glenohumeral IR deficit, increasing the risk of shoulder injury [40,41]. ...
Citation: Batalha, N.; Sousa, J.P.; Fernandes, O.; Dias, E.; Parraca, J.A.; Villafaina, S. Abstract: Background and Objectives: The COVID-19 confinement significantly impacted the physical condition of athletes. However, the detraining impacts of this period on the shoulder rotator and range of motion in handball players have not been studied. Thus, the main aim of this study was to investigate the effect of this 11-week detraining period, imposed by the COVID-19 pandemic confinement, on the shoulder rotator isokinetic profile (peak torque, ratio, fatigue index), shoulder rotator and flexion range of motion, and ball release velocity in handball players. Materials and Methods: A total of 16 handball players, with a mean age of 22.38 (5.28) years, participated in this study. The isokinetic strength was assessed using two protocols (three repetitions at an angular velocity of 60 • /s and 20 repetitions at an angular velocity of 180 • /s). In addition, the range of motion and ball release (at jump and standing shots) were measured. All these measurements were assessed before and after the COVID-19 confinement. Results: The results showed a significant reduction in the peak torque of the external rotation of their dominant and non-dominant shoulders. In addition, confinement significantly increased the fatigue index of external rotation and internal rotation and reduced the range of motion of internal rotation. Additionally, the ball release velocity during standing and jump shots was significantly reduced. Conclusions: These results suggested that strengthening external and internal rotation as well as recovering the internal rotation range of motion may be necessary after a detraining period in order to prevent shoulder injuries.
... The most classic overhead sports are baseball (pitcher), javelin throw, volleyball (serve and attack) and tennis (serve and smash). These sports have in common the phases of the athletic gesture and a high risk of injury of the joints and the muscles of the upper limb [1][2][3][4][5][6][7][8][9][10]. ...
Background: Swimming and, specifically, front crawl, can be included among the "overhead" sports. Overhead sports are a risk factor for some problems of the musculoskeletal system, especially the shoulder. The aim of the study was assessing the incidence of shoulder and neck pain in a Masters Swimming Team and its correlation with the crawl stroke. Methods: It is an observational study through video-analysis of the stroke and a questionnaire. The participants are 61 athletes of a Master team, whose prevailing training stroke was the front crawl were selected for the present study. Their stroke was analyzed during training by a go-pro camera mounted on a sliding trolley on a track, evaluating with their trainer their technical defects. A questionnaire about frequency of shoulder and neck pain during the last five years was administered to all the participants at the study. Results: From the questionnaire, 45 and 55 out of 61 athletes had suffered from shoulder pain and cervical pain, respectively. Both types of pain were correlated with the weekly swimming volume. The swimmers with hyperflexion of the wrist and prolonged internal rotation in the pulling phase had shoulder problems. Those who suffered from current shoulder pain reduced the underwater time. The four swimmers with an excessive body roll during breathing and those who kept their heads extended, reported cervical pain. Conclusions: Shoulder and neck pain could be prevented with the correction of specific technical errors in crawl stroke.
... 11 For example, college softball pitchers tend to demonstrate less upper extremity range of motion when compared to high school-level pitchers. 12 This decrease in mobility could be a contributing factor to increased injury rates 13 and has led coaches to consider implementing dynamic warm-ups and preventative exercise programs. 14 Injury prevention programs generally consist of stretching or strengthening exercises that are designed to maintain adequate mobility and strength throughout the season. ...
Background
Approximately 50 percent of softball injuries are the result of overuse or chronic conditions. However, research exploring preventative measures for softball players is limited and usage of injury prevention strategies among softball coaches is unknown.
Hypothesis/Purpose
This survey aimed to investigate if softball coaches are implementing injury prevention programs to reduce injury and improve the performance of their players. The secondary purpose was to identify barriers to the implementation of injury prevention programs. Finally, this survey explored the coaches’ knowledge of injury risk factors and their views on design and usage of preventative programs.
Study Design
Descriptive cross-sectional survey
Methods
A 35-item survey was sent to approximately 14,000 high school and collegiate fastpitch softball coaches throughout the United States. Data were collected over a three-month period with an overall response rate of 1.2%.
Results
Among responding coaches, 45.9% (n=79/172) reported implementing injury prevention programs. Coaches who implement injury prevention strategies most frequently utilize team-based programs (68.8%, n=52/93) compared to group-based (19.0%, n=15/93) or individualized programs (15.2%, n=12/93). Coaches who do not use preventative programming reported that being unsure of what program to perform (53.8%, n=50/93) and not having enough staff (20.4%, n=19/93) were the greatest barriers to implementation. Although over 50% of coaches recognized arm fatigue/overuse (27.9%, n=48/172) and decreased core strength (22.7%, n=39/172) were important risk factors, 36% (n=94/172) “disagree” that softball pitchers should adhere to pitch counts and 90% (n=83/92) believe that preventative programming for pitchers and position players should be similar.
Conclusion
Less than 50 percent of softball coaches implement exercise programs to prevent injury. Limited familiarity with effective program design, inadequate staffing, and inconsistent risk factor awareness are the major contributors to lacking implementation. Collaboration between rehabilitation professionals and softball coaches regarding preventative programming should be considered.
Level of Evidence
Level 3
©The Author(s)
... Injuries of the shoulder girdle in athletes, for whom overhead movements are typical, are mainly caused by repetitive movements (Olsen et al., 2006) or muscle fatigue (Hutchinson et al., 1995) and may be associated with scapular dyskinesis (Silva et al., 2008;Kawasaki et al., 2012), rotator cuff muscle injury or weakness (Bolach et al., 2019;Byram et al., 2010), or a deficiency in the internal rotation of the glenohumeral joint (Keller et al., 2018;Wilk et al., 2011;Shanley et al., 2011). If there is a change in the range of motion of the glenohumeral joint, the pressure on the front muscles of the shoulder increases and this can lead to the impingement syndrome (Świtoń et al., 2017;Kibler, 2014). ...
Crossminton is a sport that combines elements of squash, badminton and tennis, creating a new sport, which is currently being played all over the world. The aim of our study was to identify and compare the bilateral differences in the internal and external rotation of the glenohumeral joint of crossminton players. The subject of our study were 13 crossminton players from Slovak Republic (25.1 ±9.3 years; 172.8 ±9.1 cm; 71.8 ±16.1 kg). The range of motion of internal (IR-ROM) and external rotation (ER-ROM) of the glenohumeral joint was measured bilaterally using a standard two-arm goniometer. Bilateral comparison, decimal and sport age pairwise comparisons were carried using the T-test for independent samples. Results point to the occurrence of glenohumeral joint adaptation. Given the bilateral differences, the dominant shoulder has lower IR-ROM (p < 0.05) and higher ER-ROM (p < 0.05) than the non-dominant shoulder. GIRD (IR difference > 13 °) was observed in 4 players. The decimal age of the players did not have a significant impact on the rotation values of the glenohumeral joint. Only IR-ROM of the dominant upper limb was lower with the growing sport age of the players (p < 0.05). Given the fact that adaptations in ROM of glenohumeral joint promote an increased injury risk, the present study reveals the relevance of monitoring and finding differences between upper limbs in crossminton players.
... [34] Bununla birlikte pek çok çalışmada özellikle fırlatma sporları oyuncularının omuzlarında biyomekanik değişiklikler meydana geldiği bildirilmiş, glenohumeral iç rotasyon eksikliği, rotator manşet kuvveti eksikliği ve skapular diskinezi olası risk faktörleri olarak tanımlanmıştır. [33,[35][36][37][38][39] Beyzbol oyuncularının atış pozisyonu ve atış şekli incelendiğinde topa vuruş esnasında kolun gerilmesi nedeniyle üst ekstremitede baskı oluşur ve bu durum omuz biyomekaniğinin değişmesine sebep olur. Lintler ve ark. ...
